<%@ page language="java" import="java.util.*" pageEncoding="utf-8"%>
<%@ taglib uri="/struts-tags" prefix="s" %>
<%
String path = request.getContextPath();
String basePath = request.getScheme()+"://"+request.getServerName()+":"+request.getServerPort()+path+"/";
%>
<div class="pageContent">
	<form method="post"  action="<%=basePath%>customer/alter_History.action" 
		class="pageForm required-validate" onsubmit="return validateCallback(this);">
		<div class="pageFormContent" layoutH="56">
				<p>
				<label>病史记录编号：</label>
				<input name="history.mrId" class="required" type="text" size="16"  maxlength="32" value="<s:property value="history.mrId"/>"  readonly="readonly"/>
			</p>
			  <p>
				<label>客户编号：</label>
				<input name="customer.customerId" class="required" type="text" size="16"  maxlength="32" value="<s:property value="history.cinfo.customerId"/>" readonly="readonly"/>
			</p>
			<dl class="nowrap">
				<dt>药物过敏史：</dt>
				<dd><textarea rows="2" cols="80" name="history.drugAllery" class="textInput"><s:property value="history.drugAllery"/></textarea></dd>
				</dl>
				<dl class="nowrap">
				<dt>危险环境接触史：</dt>
				<dd><textarea rows="2" cols="80" name="history.envExplosure" class="textInput"><s:property value="history.envExplosure"/></textarea></dd>
			</dl><dl class="nowrap">
				<dt>既往病史：</dt>
				<dd><textarea rows="2" cols="80" name="history.pastIllness" class="textInput"><s:property value="history.pastIllness"/></textarea></dd>
			</dl><dl class="nowrap">
				<dt>既往手术：</dt>
				<dd><textarea rows="2" cols="80" name="history.pastSurgery" class="textInput"><s:property value="history.pastSurgery"/></textarea></dd>
			</dl><dl class="nowrap">
				<dt>既往外伤：</dt>
				<dd><textarea rows="2" cols="80" name="history.pastInjury" class="textInput"><s:property value="history.pastInjury"/></textarea></dd>
				</dl><dl class="nowrap">
				<dt>既往输血：</dt>
				<dd><textarea rows="2" cols="80" name="history.pastTransfusion" class="textInput"><s:property value="history.pastTransfusion"/></textarea></dd>
				</dl>
		</div>
		<div class="formBar">
			<ul>
				<!--<li><a class="buttonActive" href="javascript:;"><span>保存</span></a></li>-->
				<li><div class="buttonActive"><div class="buttonContent"><button type="submit">保存</button></div></div></li>
				<li>
					<div class="button"><div class="buttonContent"><button type="button" class="close">取消</button></div></div>
				</li>
			</ul>
		</div>
	</form>
</div>
